Pain & Inflammation PME
A client is about to start taking oral morphine to treat acute pain from an injury. Which of the following instructions should you include when talking with the client about taking morphine? (select all that apply) a. take it with food b. rise slowly from sitting or reclining c. take it on a fixed schedule d. increase fluid and fiber intake e. do not take it before driving
a, b, d, e
A client is about to begin celecoxib therapy for osteoarthritis. You should instruct the client to watch for and report which of the following possible indications of a serious reaction to this drug? a. black, tarry stools b. polyuria c. bone pain d. dry mouth
a
A client is about to start taking tramadol to treat moderate pain. Which of the following instructions should you include when talking with the client about taking this drug? a. allow 1 hr for it to take effect b. take it on an empty stomach c. chew the ER tablets d. do not take it with grapefruit juice
a
A nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity? (select all that apply) a. diaphoresis b. palpitations c. SOB d. nausea e. diarrhea
a, d, e
kidneys inhibit
COX-1 impairs renal perfusion - decreased urine output, increased BUN/Cr
platelet aggregation inhibits
COX-1 decreases platelet aggregation - anticoagulant effects (bleeding, bruising)
platelet aggregation stimulates
COX-1 enhances platelet aggregation
ibuprofen
NSAID
A nurse is planning care for a client who has stared taking prednisone. Which of the following interventions should the nurse include? a. monitor the client's blood glucose b. administer an antacid 30 min prior to prednisone c. administer aspirin rather than NSAIDs if the client has pain d. monitor the client for hyperkalemia
a
A nurse is reviewing the drug list for a client who has a new prescription for allopurinol. The nurse should identify that which of the following drug interacts with allopurinol? a. warfarin b. ibuprofen c. insulin d. furosemide
a
A nurse is teaching a client who has a new prescription for allopurinol. Which of the following instructions should the nurse include? a. avoid driving or activities that require mental alertness b. avoid crushing the tablets c. limit fluid intake during therapy d. limit potassium while taking allopurinol
a
A nurse is teaching a client who is taking allopurinol about minimizing adverse effects. Which of the following instructions should the nurse include? a. eat a small meal before taking the drug b. suck on hard candy or chew gum c. take a stool softener daily d. avoid the use of NSAIDs
a
As the healthcare provider prepares to give the client morphine IV for pain, she makes sure she has which of the following drugs available? a. naloxone b. protamine sulfate c. flumazenil d. physostigmine
a
butorphanol
anesthesia adjunct
A client who is receiving chemotherapy takes allopurinol prior to the chemotherapy to reduce the risk for which condition? a. agranulocytosis b. hyperuricemia c. aplastic anemia d. thrombocytopenia
b
A nurse is caring for a client who has a new prescription for celecoxib. The nurse should tell the client to report which of the following adverse drug reactions? a. tinnitus b. chest pain c. constipation d. diaphoresis
b
A nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome? a. muscle pain b. fever c. anxiety d. tremors
b
A nurse is caring for a client who takes low-dose aspirin to prevent cardiovascular events. The client asks the nurse about taking ibuprofen to treat rheumatoid arthritis. Which of the following responses should the nurse make? a. "ibuprofen will increase your risk for developing salicylism" b. "ibuprofen will reduce the cardioprotective effects of low-dose aspirin" c. "low-dose aspirin will reduce the anti-inflammatory effects of ibuprofen" d. "low-dose aspirin will reduce the analgesic effects of ibuprofen"
b
A nurse is caring for a client who has a prescription for aspirin to treat an ankle sprain. The nurse should instruct the client to report which of the following adverse drug reactions? a. polyuria b. bone pain c. weight gain d. infection
c
A nurse is caring for a client who currently takes furosemide and has a new prescription for prednisone. The nurse should monitor the client for which of the following manifestations during concurrent use of the two drugs? a. hypercalcemia b. hypoglycemia c. hypothermia d. hypokalemia
d
A nurse is caring for a group of postoperative clients. The nurse should identify that morphine is contraindicated for which of the following clients? a. a client who had a mastectomy b. a client who had a knee arthroplasty c. a client who had a colectomy d. a client who had a cholecystectomy
d
A nurse is reviewing the medical record of a client who reports taking acetaminophen at home. The nurse should identify that which of the following client conditions is a contraindication for acetaminophen? a. asthma b. DM c. HF d. alcohol use disorder
d
A provider prescribes prednisone for a client who has type 1 DM. Recognizing the risk for an adverse drug reaction to the prednisone, which of the following precautions should the primary care provider take for this client? a. reduce the insulin dose b. increase carbohydrate intake c. reduce the prednisone dose d. increase serum glucose monitoring
d
acetaminophen
fever reduction
prednisone
glucocorticoid
morphine
opioid analgesic
naloxone
opioid antagonist
prednisone
prevention of organ rejection
morphine
sedation
gastric mucosa inhibits
COX-1 gastric mucosa not protected - ulcer development
gastric mucosa stimulates
COX-1 gastric mucosa protected - increased production of mucus, decreased production of stomach acid
kidneys stimulate
COX-1 promote kidney profusion
A nurse is caring for a client who is taking naloxone to treat acute morphine toxicity. The nurse should monitor the client for which of the following adverse drug reactions? (select all that apply) a. increased RR b. increased pain c. thrombophlebitis d. ventricular arrhythmias e. HTN
a, b, d, e
A nurse is caring for a client who asks about taking acetaminophen. The nurse should identify that acetaminophen is indicated for which of the following conditions? (select all that apply) a. to reduce fever b. to decrease inflammation c. to relieve mild pain d. to promote sedation e. to alleviate anxiety
a, c
A nurse is reviewing the medical record of a client who has a new prescription for tramadol. The nurse should identify that which of the following conditions is a contraindication for tramadol? a. hyperthyroidism b. seizure disorder c. rheumatoid arthritis d. urinary incontinence
b
Because the client is taking celecoxib for osteoarthritis, he knows to watch for and report which of the following possible indications of an adverse reaction to celecoxib? a. tinnitus b. weight gain c. anxiety d. tremor
b
Butorphanol is an unsafe analgesic choice for clients who a. take glucocorticoids for RA b. use a fentanyl patch for chronic pain c. have type 1 DM and use an insulin pump d. take warfarin for thrombophlebitis
b
Which of the following instructions should the healthcare provider give the client regarding the use of aspirin prior to the surgery? a. continue to take it once a day b. stop taking it 1 week before surgery c. increase the dose to twice a day d. reduce the dose to every other day
b
A nurse is caring for a client who is receiving morphine to relieve severe pain. The nurse should monitor the client for which of the following adverse drug reactions? a. diarrhea b. urinary retention c. respiratory depression d. sedation e. orthostatic hypotension
b, c, d, e
A nurse is teaching a client who has a new prescription for allopurinol. The nurse should instruct the client to report which of the following adverse drug reactions? a. palpitations b. sore throat c. vertigo d. bruising e. vision changes
b, c, d, e
A nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include? (select all that apply) a. reduce the dose during periods of stress b. discontinue the drug gradually c. report illness or infection d. increase intake of calcium and vit D e. monitor for signs of gastric bleeding
b, c, d, e
A nurse is caring for a client who has a new prescription for butorphanol. The nurse should monitor the client for which of the following adverse drug reactions? (select all that apply) a. infection b. nausea c. tachycardia d. dizziness e. headache
b, d, e
A nurse is caring for a client who is opioid dependant and has a new prescription for butorphanol. The nurse should monitor the client for which of the following manifestations of abstinence syndrome? (select all that apply) a. bronchospasm b. vomiting c. peripheral edema d. abdominal cramps e. HTN
b, d, e
A client arrives at the ER immediately following an acetaminophen overdose. Which drug should you prepare to administer? a. atropine b. naloxone c. acetylcysteine d. flumazenil
c
A nurse is caring for a client who has a new prescription for prednisone for long-term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse drug reactions? a. PE b. hepatitis c. bone loss d. breast cancer
c
A nurse is reviewing the medical record of a client who has a new prescription for celecoxib. The nurse should identify that which of the following conditions is a contraindication to celecoxib? a. rheumatoid arthritis b. ankylosing spondylitis c. sulfonamide allergy d. adrenocortical insufficiency
c
In addition to celecoxib, the client takes low-dose aspirin daily for which of the following purposes? a. decreases the risk for anaphylaxis b. potentiates the therapeutic effects of celecoxib c. reduces the risk of a cardiovascular event d. increases renal perfusion
c
A client is about to start taking aspirin to prevent cardiovascular events. You should instruct the client to watch for and report which adverse drug reaction of aspirin? a. dyspnea b. constipation c. calf pain d. petechiae
d
The healthcare provider prepares to give the client morphine IV for pain. Knowing the adverse drug reactions of morphine, she should monitor the client for which of the following? a. jaundice b. fever c. hypertension d. respiratory depression
d
tissue injury/pain inhibits
COX-2 decreases pain
tissue injury/body temp stimulates
COX-2 increases body temp
A nurse is teaching a client who has a new prescription for tramadol. Which of the following instructions should the nurse include? (select all that apply) a. increase fiber and fluid intake b. take the drug with food c. avoid driving after taking the drug d. change positions gradually e. reduce exercise level temporarily
a, b, c, d
A nurse is caring for a client who is about to begin taking aspirin. The nurse should instruct the client to report which of the following manifestations of salicylism? (select all that apply) a. fever b. tinnitus c. diaphoresis d. thrombophlebitis e. dizziness
a, b, c, e
A nurse is caring for a child who has a viral infection. The nurse should identify that which of the following drugs can increase the risk of Reye syndrome in children who have viral infections? a. butorphanol b. acetaminophen c. tramadol d. aspirin
d
tissue injury/pain stimulates
COX-2 causes pain
tissue injury/body temp inhibits
COX-2 decreases body temp
tissue injury/inflammation inhibits
COX-2 decreases inflammation
tissue injury/inflammation stimulates
COX-2 promotes inflammation
